One of the most significant improvements made in the field of cosmetic surgery has been a new type of liposuction surgery, known as tumescent liposuction or the tumescent technique. The tumescent technique, invented by Dr. Jeffrey A. Klein, M.D. in 1985, uses a large volume of fluid that is infiltrated into a targeted fat compartment to produce swelling and firmness therein. The fluid generally comprises a very dilute epinephrine solution and a dilute anesthetic solution which cooperate to produce vasoconstriction and a profound anesthesia within the targeted fat compartment while further maintaining the fat in a tumescent state.
While the fat is maintained in this tumescent state, a microcannula is systematically inserted into the fat compartment in a series of elongate paths. The cannulas, which are connected to a suction device, extract the suspended fatty tissue in elongate, cylindrical portions which, as a result, create a network of many small tunnels running throughout the targeted fat compartment. Having selectively removed the fat from within the fat compartment, and thus forming the series of tunnels therein, the excess epinephrine/anesthetic solution is allowed to drain through the incisions through which the procedure is performed. Accordingly, over time the tunnels formed by the cannulas collapse, and ultimately cause the compartment to assume the desired contour.
The tumescent liposuction technique has been widely praised and has been written about extensively. Among the numerous articles disclosing the specifics of the tumescent liposuction technique include: Klein, M.D., Jeffrey Alan, The Tumescent Technique: Anesthesia and Modified Liposuction Technique, Dermatologic Clinics, Vol. 8, No. 3, July 1990; Klein, M.D., Jeffrey A., The Tumescent Technique For Lipo-Suction Surgery, Am. J. Cosmetic Surg., Vol. 4, No. 4, 1987; Klein, M.D., Jeffrey A., Tumescent Technique For Regional Anesthesia Permits Lidocaine Doses of 35 mg/kg For Liposuction, J. Dermatol. Surg. Oncol., 16:3, March 1990; Klein, M.D., Jeffrey A., Tumescent Technique For Local Anesthesia Improves Safety In Large-Volume Liposuction, Plastic and Reconstructive Surgery, Vol. 92, No. 6, November 1993; and Klein, M.D., Jeffrey A., Anesthesia For Liposuction and Dermatolocic Surgery, J. Dermatol. Surg. Oncol., 14:10, October 1988, the teachings of each being expressly incorporated herein by reference.
The tumescent liposuction technique advantageously allows for large amounts of fat to be removed from the body with virtually no blood loss. Additionally, the tumescent technique has further proven to be less painful, has minimized post-operative recovery time, and has produced optimal cosmetic results as compared to other liposuction procedures. Importantly, the tumescent technique, by using local anesthesia, advantageously avoids the need for intravenous sedatives, narcotic analgesics, or general anesthesia, all of which having greater risks associated therewith.
However, despite its advantages, tumescent liposuction surgery can produce significant aesthetic defects and patient dissatisfaction if improperly performed. Such risks are likely when the patient is improperly positioned during liposuction, and are especially likely during liposuction of the lateral thigh. In this regard, of all areas treated by liposuction, the lateral thigh is probably the most vulnerable to poor in intra-operative positioning.
With respect to liposuction of the lateral thighs, such improper intra-operative positioning may form a topical distortion of the thigh's subcutaneous fat compartments, known as a lipowarp. One special type of lipowarp, which is frequently encountered during liposuction of the lateral thigh, known as the trochanteric pseudobulge, occurs during adduction of the thigh. Such adduction causes the greater trochanter of the femur to protrude outwardly, thus elevating and distorting the overlying fat and creating a "pseudobulge". The greater the degree of thigh adduction, the greater the size of the pseudobulge, which is maximized when an individual assumes a lateral decubitus high-step position, namely, when the hip is flexed forward and the thigh adducted. As is known, when doing liposuction with a pseudobulge, there is a tendency to overcompensate and remove too much fat, thereby creating a trochanteric lipotroph (i.e., a discrete depression of skin of the trochanter caused by localized excessive liposuction).
Current intra-operative positioning for liposuction of the lateral thighs, however, presently fails to adequately address the problem created by the outward protrusion, or pseudobulging of the greater trochanter. In this regard, the supine and prone position presents both a warped target and an awkward access for the surgeon. Likewise, the weight of the patient's body compresses the targeted fat compartment in the anterior-posterior direction and simultaneously causes and accentuates the pseudobulge. The lateral decubitus position likewise has drawbacks insofar as in such position, the patient's upper-most thigh is slightly adducted, which thus accentuates the pseudobulge.
Ideally, the optimal position for liposuction of the lateral thighs is a modified lateral decubitus position that approximates the anatomic position. In this regard, with the patient recumbent on a surgical table, the anatomic position minimizes the distortion of fatty tissues caused by altered position of subjacent musculoskeletal structures. Additionally, a patient's pre-operative shape is usually assessed with the patient standing in the anatomic position and, as such, by utilizing an intraoperative position that approximates the anatomic position, the nuances and subtleties of pre-operative shape will be more easily discerned intra-operatively. Furthermore, it is widely recognized that patients usually judge the result of their surgery while standing erect in front of a mirror in a manner that approximates the anatomic position. When surgery is done in the same position as pre- and post-operative assessment, it is more likely that the patient will be pleased with the result of the liposuction once the post-operative inflammation and swelling have subsided. Unfortunately, however, at the present time the present art is deficient in providing any support apparatus or methods that help approximate the anatomic position when the patient assumes a lateral decubitus position.
Accordingly, there in a need in the art for a surgical support device that eliminates or substantially minimizes the trochanteric pseudobulge during liposuction surgery. There is additionally a need in the art for such a device that enables a patient to approximate the anatomic position while the patient assumes a lateral decubitus position. The art is further deficient in providing a surgical support device for positioning a respective one of a patient's thighs that is effective, easy to use, inexpensive to manufacture, and of simple construction.